Are these “mini” procedures better than their alternatives? This is difficult to answer because it is impossible to define “better.” Yes, the scars are shorter and the recovery is faster. There is generally less bruising, swelling, and pain (although pain is subjective and not related to the length of the scar) after your plastic surgery.

The problem is that these “mini” procedures are just that….mini. They are a smaller version of the traditional procedures that they have evolved from. Oftentimes, there is less “internal work” performed. For example, a “mini facelift” does improve the mid face and cheeks, but does not allow for significant correction of the aging jawline and neck. For the person who only needs midface correction, this is a great option. However, many of my patients require rejuvenation of the lower face and neck as well, making a “mini facelift” suboptimal. A “mini tummy tuck” will improve the area of the abdomen beneath the belly button. There is a shorter scar as compared to a traditional tummy tuck and the recovery is faster; however, there is no improvement of the area above the belly button which is an area that bothers most people. A “mini brachioplasty” limits the scar to the armpit and eliminates the sometimes unsightly scar of a traditional brachioplasty that extends from the armpit down to the elbow. Eliminating this scar also eliminates the ability to remove excess skin in all directions, reducing the amount of improvement that can be achieved.

For the lucky few, a “mini” procedure may be exactly what they need – a person with early signs of aging and only mild skin excess. But for the majority of people, the decision for a traditional versus a “mini” procedure is an evaluation of cost and benefit. Is the shorter scar and more rapid recovery worth the small sacrifice in cosmetic surgery results? I commonly ask my patients “would you be willing to accept a 20% less improvement in results, in exchange for a recovery that is half as long?” If the answer is “yes”, then a “mini” procedure is a viable option. If the answer is “no”, then a traditional approach is more appropriate.

Many plastic surgeons in new york have marketed these “mini” procedures as a way to make themselves stand out in a competitive marketplace – myself included. I believe there is a role for these procedures but, it is important to be honest about the results these procedures offer. I never tell my patients that these “mini” procedures are better. Rather, I explain that the smaller, less invasive procedure offers a more rapid recovery and potentially less pain, there may be some sacrifice in terms of overall results. Many of my patients do accept this sacrifice and elect for the “mini” procedure. In fact, I perform more of these “mini” procedures then their traditional counterparts and my patients have been happy.

It is indisputable that larger incisions lead to longer scars and more potential for post-operative bruising, swelling, and pain. But larger incisions allow for better visualization and more “internal work” , often resulting in a better overall cosmetic outcome.

I tell my patients that in general, the more they are willing to accept in terms of scars, the better contour I can create. So, at least in terms of plastic surgery, size DOES matter.

As a society, we tend to focus on the bad outcomes, because this is what sells the magazines. Moreover, “regular” people probably derive some sort of pleasure (albeit twisted) in famous celebrities who always seem to get whatever they want, being the victims of “bad plastic surgery.”

But, the real truth is that there is excellent plastic surgery being performed everyday on celebrities and non-celebrities. Modern techniques for surgery allow for smaller incisions that are better hidden, more rapid recoveries, and more “natural” results. Gone are the days of dramatic surgical changes and barely recognizable post-surgical faces.

Facelifting technique has seen the greatest advancement. The facelifts of the 1980’s with the windswept look, overtight skin, and upturned mouth reminiscent of “The Joker” are no more. Plastic surgeons now “lift” and “reposition” the deep structures of the face (the fat pads and muscles), and very little is done to the skin. In fact, after the underlying structures are repositioned into a youthful position, the skin is simply “redraped” and not pulled tight. You would be surprised at how little skin is actually removed during a facelift when it is done correctly.

I will share a little trick that I do with every one of my pre-operative facelift patients in consultation. To show what you will look like with a very well done (and natural) facelift, lay on your back and look at yourself in a handheld mirror. Impressive, right? This allows gravity to show you where everything should be.

Additionally, non-surgical treatments have evolved as well. Chemical peels should no longer result in that obvious shiney, over-smooth, waxy skin. Injectable fillers can be done conservatively so that they restore volume and fill lines, without making someone look like they have been over-inflated. Botox and Dysport can soften lines and do not have to completely prevent movement. That “frozen look” that people fear is a result of a bad injector, not the injection! Believe it or not, it is possible to eliminate lines on your forehead AND be able to lift your eyebrows!

My point is that there are excellent plastic surgeons that perform surgeries and injections that rejuvenate and improve, without making you look ridiculous and “overdone”. My patients obviously want to look different (ie. better) but they don’t want people to know exactly what they had done. They want someone to ask if they got their hair colored or lost weight, when the truth is that they had their eyes or face done.

Finding the right surgeon is the key. So, as long as there remain bad plastic surgeons (or non-plastic surgeons trying to act like plastic surgeons), the Weeklies will continue to have lots of content for the “bad plastic surgery” section. Nobody wants to read about the good results.

If you are interesed in seeing before and after photos of plastic surgery procedures performed by me, visit his photo gallery, or contact my office to schedule a consultation.

• People are beginning to plan for the summer: This is the time of year when summer vacation plans are made and people begin to dream about long days on the beach or by the pool. With warm weather comes bathing suits and more revealing clothes. This idea usually motivates people to improve their body. Gyms get busier, and so do plastic surgeon offices. Because it takes several months for the body to completely heal after any cosmetic procedure, I recommend that breast and body contouring be done during this time of year, to ensure the best possible results for the warm summer months.

 

• Recovering from surgery in the cooler months is more comfortable: Routine post-operative care usually involves dressings, bandages, and tight compression garments worn under clothes. In cooler months, this is more comfortable. By the time the warm months come around, it will not be necessary to wear all these extra layers. While I do perform a lot of plastic surgery during warm months, my patients are aware that perspiration may cause some irritation to healing incisions.

 

• A good time of year to dedicate to yourself: The hustle and bustle of the winter holiday season is now over, and people tend to have less social and family commitments this time of year. This makes it a perfect opportunity to dedicate some time to yourself and your recovery.

 

• Anticipated Tax refunds: As we enter tax season, many people are anticipating a tax return. Even a small amount of tax refund may make a huge difference in paying for your plastic surgery. Also, there are many different finance options now available for plastic surgery, and your anticipated tax refund may make financing a good option. Many companies have 0% options for a variable amount of time. Many of my patients are signing up for 3-6 months 0% financing, knowing that the tax refund can be applied to partially or totally pay for the surgery.

 

• Plastic Surgery Discounts: While many surgeons only try to improve business during slow times, many (like myself) see a great opportunity to increase business during this very busy season through special pricing. You will be surprised to find very good discounts for surgical procedures this time of year.

As we enter plastic surgery “busy season”, this may be a good time to look into making the improvements in your body that you have always thought about. The timing is right, contact New York City Plastic Surgeon Dr. Schulman for a consultation.

1. Permanent Lip Implants – A large number of men and women request fuller lips.  This has traditionally been done using temporary injectable fillers such as Restylane and Juvaderm. In good hands the results are excellent, but temporary.  The cost varies by geographic region and the specific filler chosen, but starts around $700.  With  patients returning on average of every 6 months (sometimes sooner), it will cost you approximately $1400 per year and $4200 over three years.  Now there is a permanent solution – PermaLip. These are soft silicone, permanent lip implants.  With a cost of $1800 per implant, the cost savings is enormous.  I have had excellent results with this safe and permanent solution for those who desire fuller lips.  The demand was high for this at the end of 2009 and I have no doubt that the popularity will only increase.  On a personal note, this makes me very happy given that I am one of only a few plastic surgeons experienced with this procedure.
2. Earlobe Rejuvenation – Long, thin, sagging earlobes are a tell-tale sign of a person’s age and often neglected. I have noticed in my own practice that earlobes age just like the rest of our face and body.  This is why I offer my patients options for earlobe rejuvenation. This may include “plumping” them with fillers, or shortening them by removing excess skin in a simple in-office procedure.  I anticipate that this inexpensive, simple procedure will continue to gain demand in 2010.
3. Adjustable Breast Implants – Selecting an implant size can be a source of tremendous anxiety for the patient. In fact, the most common reason for re-operation after breast augmentation is to change the size of the implant.  Also, many women have pre-existing breast asymmetry, making implant selection difficult because different size implants are required. Post-operative adjustable saline implants can solve this problem by allowing a physician to change the size of the implant through a tiny access port beneath the skin.  While this is not designed for increasing or decreasing your breast size based on your outfit, it is designed to allow the patient to take their time in deciding the final volume of the implants. It is common for breast implants to appear “too large” immediately after surgery when they are swollen and in a high position. After the swelling goes down in several weeks and months, it is common for the patient to complain that they are now “too small.” Now more saline can be added to the implants resulting in the desired size.  The access ports can then be removed with a simple in-office procedure.
4. Belly button enhancement – Another procedure gaining popularity in my practice is belly button surgery. Men and women come to me and complain about the appearance of their belly button. They may feel that it is “too large” or that they what the “outie” made into an “innie.”  Also, the belly button may have been distorted because of a hernia.  Belly Button Rejuvenation can improve the appearance of your belly button with a short in-office procedure using local anesthesia.  Last year I was quoted in the New York Daily News in reference to Victoria Secret Supermodel Karolina Kurkova’s (lack of a) belly button. After that, belly button revisional surgery has become one of the most requested procedures that I performed in 2009 and from the looks of my upcoming schedule over the next few months, this trend will continue.

Only time will tell if my predictions for 2010 come true. I am certain that they will be among the hottest procedures in my practice during the upcoming year, but national trends are difficult to predict.  I look forward to my December 2010 blog entry when I reflect on my predictions.

A “Mommy Makeover” refers to the surgical correction of these common post-pregnancy changes. It usually involves an abdominoplasty, liposuction of the hips and thighs, and a breast lift with or without breast implants.  Depending on the skill of the surgeon and the motivation of the patient, these procedures may be combined into one surgical operation.

A tummy tuck, or abdominoplasty, will remove the excess skin of the lower abdomen.  Pregnancy stretches out the skin and no amount of diet and exercise can “shrink” this lax skin.  As I often tell my patients, you cannot diet or exercise away skin. This skin laxity often gets more pronounced after each pregnancy. More importantly, an abdominoplasty will tighten the underlying abdominal muscles that have been weakened from the pregnancy. 

The hormonal changes of pregnancy also stimulate the body to increase its fat reserves. As a result, an increased amount of fat is stored in areas such as the hips and thighs.  This fat is extremely resistant to exercise, making it almost impossible to eliminate through diet and exercise. Liposuction can permanently remove this fat and improve the shape of the lower body.

The breasts are extremely sensitive to fluctuations in weight and hormone, two things that commonly accompany pregnancy. Most women experience an increase in breast size during pregnancy and during breast feeding. However, the breasts often decrease rapidly in size. This can result in breasts that are smaller and sag more than the woman’s pre-pregnancy breasts.  The rapid change in breast size may also result in stretch marks.  A breast lift will lift the breasts and eliminate the “sag”.  A breast implant may also be placed during this breast lift in order to increase breast size.

A “Mommy Makeover” is increasing in popularity as women look for ways to reverse the effects of pregnancy and return their body to a pre-pregnancy state.  This is a commonly performed procedure for woman in their late 30s to mid 40s who are not planning future pregnancies.  While many women prefer to undergo multiple procedures in one operation, it is not necessary.  The individual components of the “Mommy Makeover” can be performed in separate operations.

If you are interested in breast and body contouring procedures, be sure to have a consultation with a board certified New York City plastics surgeon.